Re: tarsal tunnel syndrome

Posted By CCF Neurology* on July 31, 1998 at 10:23:14:

In Reply to: tarsal tunnel syndrome posted by Cindy on July 29, 1998 at 17:36:30:






I had tarsal tunnel release surgery on my right ankle in early January of this year.  The problem is caused by a previous  fracture of this ankle years ago.
I have been having continual problems with pain, stiffness, heel pain, some numbness.  These occur especially after walking lots.  Although the symtoms (symptoms) are not as severe as before the surgery, I can only think that they will continue to escalate and become like they were before the surgery.  Should these symptoms still be occuring?  What could be causing this to happen?  Could the symptoms escalate again?  I have also read that tarsal tunnel can reoccur; is this possible?  Thanks.
Dear Cindy,
Tarsal tunnel syndrome is caused by entrapment of the posterior tibial nerve behind the inner ankle. Burning pain occurs in the toes and the sole of the foot.  If an additional sensory branch is included there may be pain in the heel as well.  Examination of the foot usually reveals loss of sensation  in those regions and wasting of the feet muscles. Tapping on the area above the ankle or turning the foot outward may provoke shooting pains and numbness in the region.  EMG/NCS should be performed to confirm the entrapment of the nerve.  Many suspected case of tarsal tunnel syndrome turn out to be a generalized peripheral neuropathy.  Symptoms could reoccur if the etiology was something other than taral tunnel or if there was incomplete release. Medications such as NSAIDS and TCA's may also help with neuropathic pain.  Local steroid injections may also provide temporary relief.  A repeat EMG/NCS may be of benefit. Discuss these options with your doctor. If you are interested  in getting an avaluation at CCF, call 1-800-CCF-CARE. Good Luck.